A study published for access to legal cannabis stores is associated with a reduction in opioid-related deaths in the United States, especially those related to synthetic opioids such as fentanyl. The BMJ today.
Opioids are “morphine” -type medications that relieve short-term (acute) pain and end-of-life pain. There is little evidence that it is useful for long-term (chronic) pain, but it is often prescribed for this reason.
This has led to widespread misuse and a sharp rise in overdose deaths, especially in the United States. In 2018, more than 46,000 fentanyl-related deaths occurred, accounting for more than two-thirds of all U.S. opiate-related deaths that year.
Some studies have suggested that increased access to cannabis stores (legally authorized to sell medical and recreational cannabis) may help reduce opioid-related deaths, but the evidence so far is mixed.
To delve deeper into this, the researchers examined the relationships between medical and recreational cannabis stores (known as dispensaries) and opioid-related deaths from 2014 to 2018.
Its findings are based on data from 812 counties in the 23 U.S. states that allowed legal cannabis dispensaries to operate in late 2017.
Information on state cannabis legislation was combined with county-level data on authorized dispensaries and opiate-related mortality rates.
After monitoring population characteristics and other potentially influential factors, the researchers found that counties with a higher number of active cannabis dispensaries were associated with opioid-related mortality rates.
According to this estimate, an increase of one to two dispensaries in a county was associated with an estimated 17% reduction in all opioid-related mortality rates.
This association was held in both medical and recreational dispensaries and appeared particularly strong for deaths associated with synthetic opioids other than methadone, with an estimated 21% reduction in mortality rates associated with a one-to-two increase. dispensaries.
An increase of two to three dispensaries was associated with an additional 8.5% reduction in all opiate-related mortality rates.
This study is the first to examine the association between active cannabis dispensary operations and opioid-related mortality rates at the finest grain county level.
However, the results are observational, so the cause cannot be determined and researchers point out that while cannabis is generally believed to be less addictive than opioids, it still carries potential harm and should not be ‘ignore public safety risks.
But they say their findings suggest “a potential association between increasing the prevalence of medical and recreational cannabis dispensaries and reducing opioid-related mortality rates.”
And they call for “a better understanding of the impact of cannabis legalization on opioid abuse and public health outcomes before policymakers can weigh the potential benefits against the harms of promoting cannabis legalization.”
In a linked editorial, the researchers argue that cannabis liberalization “cannot be seen as a remedy to the opioid crisis until there is a solid evidence base.”
While some may interpret these findings as evidence supporting cannabis liberalization to address the opioid crisis, they point out that “these findings are currently premature without evidence of causation.”
Other experimental studies that include individual-level data on people using prescription opioids and illicit opioids “would report a more nuanced understanding of opioid-cannabis substitution,” they conclude.
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Peer-reviewed? Yes (research); No (publisher linked)
Type of evidence: observational; Opinion
Topics: Legal cannabis shops
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